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Medical guidelines and references.

Endocrine & MetabolicLipids

Statins

Updated: 10th Nov 2023

Options

Simvastatin, Atrovastatin, Pravastatin, Rosuvastatin, Fluvastatin

Interaction

·         Amlodipine, verapamil, diltiazem – Reduce simvastatin to 20mg [risk of myopathy] or switch to other statin

Primary prevention

·         >= 10% 10y risk of CVD

·         TC:HDL >= 6 [Normal =< 4]

·         Simvastatin 40mg OD – Take one tablet at night – remember have blood check at 3 months ( ) and 12 months ( ) of starting treatment to monitor if impacting liver.

Secondary prevention

·         Diabetics > 40y old or establish cardiovascular disease [PAD,CHD, TIA…]

·         Simvastatin 40mg OD – Take one tablet at night – remember have blood check at 3 months ( ) and 12 months ( ) of starting treatment to monitor if impacting liver.

·         Target – [Reduction of 25% of TC or 30% of LDL] or [TC < 4 or LDL < 2] which ever greater.

·         Increase Simvastatin 80mg if target not reached.

http://www.patient.co.uk/health/cholesterol